well said Carol Ruth
> From: "Carol Thorogood" <[EMAIL PROTECTED]> > Reply-To: "Carol Thorogood" <[EMAIL PROTECTED]> > Date: Thu, 7 Mar 2002 14:51:37 +1030 > To: <[EMAIL PROTECTED]> > Subject: Re: re Apgars > > Hi > I don't know why anyone would bother with 10 minute ROUTINE Apgar scoring. > It's a screening test, not a diagnostic test. Admittedly the 5 minute one is > a fairly good predictor of whether or not asphyxia occurred in utero but it > is not a good predictor of longterm outcomes including cerebral palsy. Ten > minutely Apgar scores are sometimes used to indicate if the neonate is > responding to active resuscitation (but there are better ones). I'm not > sure where the quality co-ordinator is getting her/his evidence from but > there is plenty of good research to back up the list's claims about the > usefulness of Apgar scoring and perhaps that is the best place for 'quality' > people to base their protocols on rather than trying to prevent litigation > with more assessments of dubious worth. > > Even arterial and venous pH levels and/or base deficits aren't very good > predictors about longterm outcomes for most babies although there is a > tendency to use them routinely for 'defensive or just in case I get sued > medicine reasons'. Golly no wonder the health system is broke. > > For healthy newborns breast feeding is far more useful. A baby that can cry > and sucks at the breast soon after birth is si in all likelihood not > asphyxiated and is cheerfully making the transition to life in the big > world. So in terms of quality auditing a more meaningful assessment is to > write that the infant sucked well at the breast 'cause a compromised babe > can't suck. Why do so many people try to make such a normal event as > birthing so abnormal? Sometimes I think midwifery is quickly becoming > little more than a series of multiple assessments which are carefully > documented on an ever increasing array of forms - probably at least 10 times > in ten different places. The irony of it all is that most of it is quite > meaningless. > > Carol > > -- > This mailing list is sponsored by ACE Graphics. > Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe. > -- This mailing list is sponsored by ACE Graphics. Visit <http://www.acegraphics.com.au> to subscribe or unsubscribe.
